Rationale: New technology comes out with more advanced medical devices to improve the outcome of disease. However the higher and higher price of the devices brings out the heavy financial burden of the national health insurance (NHI). Therefore most of the new medical devices only exist in the market of out- of-pocket in Taiwan. The decision makers are often concerned if these devices ought to be covered by NHI and how do the common people think about it.
Objectives: The objective of this study is to understand the attitude of people to the advanced fracture fixation device of out-of-pocket under NHI.
Methodology: We design a contingent survey to measure the willingness-to- pay (WTP) of non-market fracture fixation devices respectively with four
characteristics of advantage including less wound size, less pain, more rapid functional recovery and no need to take out after bone healing under the scenario of leg fracture. Since April to June 2006, 349 structured questionnaires were completed by face-to-face interview in out patient department of a general hospital in central Taiwan. Multiple linear regressions were used to perform multivariate analysis.
Results: The mean WTP for the advantage is respectively from $550 (less pain) to
$833 (no need to take out, absorbable plate) that are far less than the true price of fracture devices of out-of-pocket on market. The willingness-to-pay is positive related to family income, experience of medical treatment of out-of-pocket and residency urbanization but not significantly related to health status (SF-36) and other demographic variant. The experience of previous operations doesn?t influence the WTP. Even if the people have suffered from surgeries would not pay more than those who did not have operations.
Conclusion: Under the NHI, Taiwanese patients had acceptable health care satisfaction and would rather not pay more even if they had suffered from the operations before. This WTP survey as a cost-benefit study also suggested that the advanced fracture fixation device on market with high price is not so worthwhile for Taiwanese.
